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Epilepsy - Symptom

Symptoms:

The severity of symptoms can vary greatly, from simple staring spells to loss of consciousness and violent convulsions. For most people, each seizure is similar, while some people have many different types of seizures that cause different symptoms each time. The type of seizure a person has depends on a variety of things, such as the part of the brain affected and the underlying cause of the seizure.

An aura consisting of a strange sensation (such as tingling, smelling an odor that isn't actually there, or emotional changes) occurs in some people prior to each seizure. Seizures may occur repeatedly without explanation.

Note: Disorders that may cause symptoms resembling seizures include fainting, transient ischemic attacks (TIAs) or stroke, rage or panic attacks, migraine headaches, sleep disturbances, and other disorders that cause loss of consciousness.

SYMPTOMS OF GENERALIZED SEIZURES

Generalized seizures affect all or most of the brain. They include absence seizures (also called petit mal seizures) and tonic-clonic seizures (also called grand mal seizures).

Absence seizures:

  • Minimal or no movements (usually, except for "eye blinking") -- may appear like a blank stare
  • Brief sudden loss of awareness or conscious activity -- may only last seconds
  • Can happen over and over
  • Occurs most often during childhood
  • Decreased learning (child often thought to be day-dreaming)
Tonic-clonic seizures:
  • Affects a major part of the body
  • Breathing stops temporarily, followed by sighing
  • Confusion following the seizure, lasting minutes to hours
  • Incontinence of urine (loss of bladder control)
  • Loss of consciousness
  • Rigid and stiff
  • Tongue or cheek biting
  • Weakness following the seizure (Todd's paralysis)
  • Whole body, violent muscle contractions

SYMPTOMS OF PARTIAL SEIZURES (SIMPLE AND COMPLEX)

Partial seizures may be complex or simple. Partial seizures affect only a portion of the brain.

Symptoms of simple partial (focal) seizures may include:

  • Abnormal sensations (feelings)
  • Dilated pupils
  • Feeling as if you've been in this situation before (deja vu) or never been in this situation before (jamais vu)
  • Hallucinations
  • Muscle contractions of a specific body part
  • Nausea
  • Skin flushing
  • Sweating

Symptoms of partial complex seizures may include:

  • Any of the above symptoms, along with altered consciousness or memory
  • Automatism (automatic performance of complex behaviors without conscious awareness)
  • Changes in personality or alertness, with confusion

Signs and tests:

To be diagnosed with epilepsy and seizure disorders, the person must have had spontaneous, recurrent seizures with no immediate cause. A physical examination (including a detailed neuromuscular examination) may be normal, or it may show abnormal brain function related to specific areas of the brain.

An electroencephalograph (EEG), which is a reading of the electrical activity in the brain, may show various types of seizures. In some cases it may show the location of the abnormal part of the brain where the seizures start. EEGs can often be normal in between seizures, so it may be necessary to do prolonged EEG monitoring.

Various blood tests and other tests to rule out temporary and reversible causes of seizures, may include:

Tests for the cause and location of the problem may include:

  • Reviewed last on: 5/29/2008
  • Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Foldvary-Schaefer N, Wyllie E. Epilepsy. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 52.

Krumholz A, Wiebe S, Gronseth G, et al. Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69(21):1996-2007.

Spencer SS. Seizures and epilepsy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 426.

Tomson T, Hiilesmaa V. Epilepsy in Pregnancy. BMJ. 2007;335(7623):769-73.

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